Advocating for Dignity and Choice for Persons
with Developmental Disabilities
Member Registration
Florida's Voice on Developmental Disabilities
>
Member Registration
Member Registration
*
Name(s)
*
Address
Please add your street address here.
*
City
*
State
*
Zip Code
Home Phone #
Work Phone #
Cell Phone #
FAX
Facility where friend/family resides
Please fill in information if applicable.
Name of disabled family/friend
Age of disabled family/friend
U.S. Congress District #
Use the back of your voter's registration card for information.
Florida Senate District #
Florida House District #
*
I would like to receive updates from FVDD:
Choose one
Yes
No
*
I would be willing to serve on the FLVDD Board:
Choose one
Yes
No
*
I would like to volunteer or serve on a committee:
Choose one
Yes
No
Comments
*
Username
Usernames must be at least 4 characters long
*
Password
Passwords must be at least 5 characters long
*
Password Confirm
*
Screen Name
If you leave this field blank, your screen name will be the same as your username
*
Email Address
Terms of Service
Thank you for providing your information and becoming a part of our network. We appreciate your support! A copy of the official registration (SC-05487) and financial information may be obtained from the Division of Consumer Services by calling the toll-free number 1-800-435-7352 within Florida. Registration does not imply endorsement, approval or recommendation by the State. 100% of all contributions are retained by FVDD. FVDD is a 501(c)(3) tax-emempt charity under the IRS Code.
I agree to the terms of service
*
Indicates required fields
